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Lost minds

Peter Weiss1In Memoirs of a Revolutionary Victor Serge describes the first decade of Soviet rule as displaying ‘the obscure early stages of a psychosis’, the symptoms of which became increasingly pronounced as time wore on and the defeats and corpses piled ever higher. The experience of living through the twenty-year period from the October Revolution of 1917 to the Stalinist purges (which reached their apex in 1937) he declares ‘must be a psychological phenomenon unique in history’. At various moments in the memoir the reader catches a glimpse of Serge’s wife Liuba Russakova, formerly Lenin’s stenographer, who experienced a severe mental breakdown as a result of the paranoid and persecutory atmosphere in Soviet Moscow:

I found her one evening lying in bed with a medical dictionary in her hand, calm but ravaged. ‘I have just read the article on madness. I know that I am going mad. Wouldn’t I be better off dead?’ Her first crisis had come during a visit to Boris Pilnyak’s; they were discussing the technicians’ trial, and she pushed back the cup of tea offered her, with revulsion – ‘It’s poison, don’t drink it!’ I took her to psychiatrists, who were generally excellent men, and she settled down in the clinics. However, the clinics were full of GPU people curing their nervous difficulties by exchanging secrets. She would come home again a little better for a while, and then the old story began again: ration cards refused, denunciations, arrests, death sentences demanded over all the loudspeakers placed at the street corners. [2]

But Russakova, who died in an asylum in France in 1985, is not a major figure in Serge’s memoirs. Although he occasionally mentions her and their young son Vlady, intimate scenes from his family life surface with infrequency and are presented as incidental to the main thrust of the narrative. Serge reflects that he had little interest in talking about himself except in relation to macrological social processes. As he declared on numerous occasions: ‘My duty was dictated by history itself.’ [3] Serge’s emphasis on the individual’s subordination to History (with an emphatic capital H) is central to his understanding of revolutionary subjectivity; a subjectivity paradoxically defined by the renunciation of subjectivity – ‘the individual has as much weight as straw in a hurricane’. For as Serge asserts again and again he and his comrades sacrificed their inner lives and personal identities to the revolutionary cause:

None of us had, in the bourgeois sense of the word, any personal existence: we changed our names, our postings, and our work at the Party’s need; we had just enough to live on without real material discomfort, and we were not interested in making money, or following a career, or producing a literary heritage, or leaving a name behind us; we were interested solely in the difficult business of reaching Socialism. [4]

How is it possible to reconcile these statements asserting the necessity of individuals to dissolve into the struggling collective with Serge’s fleeting acknowledgements, based on traumatic first-hand experiences, of the deep psychological wounds that history inflicted on the mental health of the people determined to alter its course? Trauma (travma) may have disappeared from Soviet psychological textbooks as anything other than a word pertaining to physical wounds, but Serge’s memoirs attest that this did not prevent those committed to solidarity (not to mention those indifferent or opposed to it) from experiencing acute psychic pain. [5] If orthodox Marxism–Leninism envisioned the ideal revolutionary vanguard as organized, disciplined and committed, marching in step from spontaneity to consciousness, then how to deal with people who experienced reality as bewildering or fragmentary, who broke down or cracked up, who hallucinated or dissociated, who were mistrustful, exhausted, frenzied or withdrawn?

Lost minds

Sedgwick, Laing and the politics of mental il ness

Hannah proctor

Peter Sedgwick and Psycho Politics

Peter Sedgwick (1934–1983), who translated Serge’s epic autobiography into English in 1963, was committed to both collective revolutionary politics and the amelioration of individual psychic suffering. In addition to his translations of Serge and active involvement in British left politics, Sedgwick had a long-standing interest in the politics of mental health. Psycho Politics, published in 1982, was Sedgwick’s magnum opus, a critique of anti-psychiatry that he worked on for many years. Born in Liverpool in 1934, Sedgwick was awarded a scholarship to study at Oxford in 1952, where he became involved in student activism and was a contemporary and friend of Raphael Samuel and Christopher Hitchens. He left the Communist Party of Great Britain following the Soviet invasion of Hungary in 1956 and was antagonistically engaged in the New Left. He was also an active member of the Socialist Review Group, later the International Socialists (for whose monthly journal he regularly wrote), but when that organization became the Socialist Workers Party in 1977 he refused to join as he claimed that its name falsely implied a connection to a working-class movement that did not exist at that time. [6] As a libertarian Marxist committed to building a democratic political movement, Sedgwick decried the ‘chauvinism, machismo and vileness’ of the British Left. [7] Sedgwick also trained as a psychologist and worked in various roles and institutions as an educational psychologist, tutor and psychological researcher until 1968, when he took up a position as a university lecturer in politics, first at York and then at Leeds. Although Sedgwick rarely reflected on his personal experiences in his published writings, he noted that he was compelled to study psychology after experiencing the British mental health care system first-hand when his adoptive mother was admitted to hospital with dementia. [8] He was found dead in a canal near his home in Shipley, Yorkshire, in 1983, following a short and tumultuous marriage to a former student almost twenty years his junior, whom he described as suffering from ‘hysterical psychosis’. [9]Psycho Politics includes critical discussions of various thinkers often bracketed together under the banner of ‘anti-psychiatry’ who Sedgwick is keen to differentiate: Erving Goffman, Michel Foucault, Thomas Szasz and R.D. Laing. Reissued by Unkant in 2015, the book is worth revisiting during the current resurgence of interest in the diffuse radical psychiatry movement. Luke Fowler won the Turner Prize in 2011 for a documentary on R.D. Laing entitled All Divided Selves and it was recently announced that David Tennant will star in a Laing biopic. 2015 saw the publication of John Foot’s The Man Who Closed the Asylums: Franco Basaglia and the Revolution in Mental Health Care (on the Italian radical psychiatry movement), a new translation of Félix Guattari’s Psychoanalysis and Transversality (discussed by Andrew Goffey in Radical Phiosophy 195),10 the republication of the 1967 Dialectics of Liberation Congress proceedings (featuring speeches by Laing and David Cooper, who coined the term ‘anti-psychiatry’ that year), and the DVD release of Peter Robinson’s 1972 documentary Asylum (Robinson had been a student of Sedgwick’s in the late 1960s).

It is Laing who dominates Sedgwick’s polemic in Psycho Politics. Indeed, in correspondence with friends Sedgwick referred to Psycho Politics as his ‘Laing book’, and he devotes two chapters to his measured attack on the ‘guru’ of anti-psychiatry. Sedgwick’s critique was addressed to a ‘mounting crisis of provision’ in mental health care, which he argued Laing’s works were not only incapable of addressing but even contributed to bringing about. [11] Sedgwick’s main issue with Laing was the flimsiness of his political convictions. But, as the crisis of provision Sedgwick identified continues to intensify, does his critique also outline counter-proposals that might be drawn on today?

Sedgwick met Laing only once, at a discussion event hosted by the University of York in 1975. There he prodded Laing on his political commitments and Laing responded by insisting that he had never been a Marxist and ‘had even forgotten signing the 1967 May Day Manifesto’ (a document expressing the New Left’s frustration with the Labour government under Harold Wilson). Sedgwick admitted being impressed by how candidly and articulately Laing spoke, and appreciated his willingness to respond to questions about the concerns that animated his earlier publications, particularly concerning the family. As he noted in a letter to his friend David Widgery: ‘He was much more lucid than I expected: not a good listener (since he is always cast in this role of monologuing guru while other people listen) but a good giver out of great vivid strings of discourse in response to some query.’ [12] Over bowls of turtle soup Sedgwick and Laing discussed Doris Lessing’s claims to have been uninfluenced by anti-psychiatry. [13] Sedgwick recalled with amused embarrassment that he had then gone to the toilet, where he and Laing stood at the urinals with another colleague between them and an overwhelmed Sedgwick found himself unable to urinate. Laing remarked that he thought it important they ‘get a grip on’ the day’s discussion, which made the successfully urinating colleague giggle. Sedgwick and Laing then exchanged stilted remarks about depressive and paranoid patients over the sink. Sedgwick later regretted not having made a clever remark about Melanie Klein. There were no paper towels in the dispenser so Laing pulled a neatly folded tissue from his pocket, dried his hands efficiently and returned to the conference: a bathetic conclusion to the long-anticipated encounter. [14] This anecdote not only conveys Sedgwick’s feelings of awkwardness around his intellectual foe, but also situates Laing in a distinctly mundane context. Sedgwick devotes far more space to a description on their toilet encounter than to his accounts of the conference itself, which conforms with his attempt in Psycho Politics to undermine the glamorous image and cult-like status of Laing: ‘He has a perfectly ordinary face and demeanour … all of these romantic gooey projections that people have had on him are very much in the eye of the beholder.’ [15] Attentive to shifts in approach across Laing’s career and careful to distinguish Laing’s own pronouncements from the accounts of others, Sedgwick was not wholly dismissive of Laing’s contributions to psychiatry. In The Divided Self (1959), Laing proposed taking an ‘existential-phenomenological’ approach to mental illness, arguing that people diagnosed with schizophrenia experienced a split within themselves and from the world around them. He insisted that the behaviour and utterances of schizophrenics were comprehensible and meaningful, and that people diagnosed with mental illnesses should be approached as subjects with particular life histories rather than as general and reified sets of symptoms. He sought to understand the experience of schizophrenia from within and interrogated the ‘nature of the barrier or disjunction between the sane and the psychotic’. [16] For Sedgwick, The Divided Self is Laing’s most persuasive and most materialist work, rooting human behaviour and perception in a social world without denying the often distressing or disorientating realities of some psychological experiences.

Sedgwick claims that between The Divided Self and Sanity, Madness and the Family (co-authored with Aaron Esterton and first published in 1964) symptoms disappear from Laing’s work into a ‘flux of social praxis’, which leads in turn to a ‘disappearance of the subject’. [17] According to Sedgwick, the detailed case histories of women diagnosed with schizophrenia which make up Sanity, Madness and the Family mark a distinct break in Laing’s oeuvre. In this work, based on clinical research undertaken at the Tavistock Clinic in London, Laing and Esterton emphasize the ‘social intelligibility’ of the patients’ conditions and, through detailed interviews with the women and their families, argue that normative familial structures produced the women’s perceptions of themselves as ‘abnormal’. By situating the behaviour of the patients in relation to the expectations of their families, the patients’ ‘symptoms’ (the frequent use of scare quotes in Laing and Esterton’s text is indicative of the shift Sedgwick identifies) are depathologized and redefined as reasonable responses to external constraints, ‘quite in keeping with the social reality in which she lived’. [18] In the concluding case history of ‘Julie’ in The Divided Self the patient’s family history is used to elucidate the causes of her current condition but her experience in the present is still understood as having an internal dimension, whereas in the later book the women’s schizophrenia is only located externally; they are presented as being equally as disturbed and (in)comprehensible as their ‘sane’ family members. For Sedgwick, this sets up too neat a distinction between internal and external experience and, moreover, between ‘normal’ and ‘abnormal’ families (tellingly, the second volume of Laing and Esterton’s study, which analysed a control group of ‘normal’ families where no one had been diagnosed with a mental illness, was never published). The Divided Self, by contrast, challenged the pejorative implications of separating the sane from the insane without denying that certain forms of psychic experience were distressing and could be treated. [19]

Sedgwick identifies two conflicting tendencies in radical psychiatry: an emphasis on the social aetiology of mental illness, on the one hand, and an insistence that mental illness is a social construct or label affixed to deviant individuals by normative cultures, on the other. Sedgwick claims that anti-psychiatrists tended to treat mental illness as distinct from other kinds of illness, with the former being understood as solely social and the latter solely physiological. He insists instead that ‘all sickness is essentially deviancy’ and that all forms of illness have a social element. [20] Mental illness (a term Sedgwick was comfortable using without scare quotes) [21] might be exacerbated by social conditions, and diagnostic labels may be reductive catch-all terms for complex sets of symptoms, but Sedgwick argues that this does not make the experience any less real or the necessity of treatment any less urgent. He also resists overemphasizing the normative assumptions terms such as ‘treatment’ imply, refusing to view all psychiatric practices as demanding an acquiesce to dominant social structures. He thus rejected an understanding of the mental health patient as ‘a social role-player rather than primarily as a bearer of pathological lesions’. [22] Existing social relations may be in some sense sick, psychiatric nosology imprecise, and available institutions and treatments inadequate, but psychic wounds are real and deep. Some people are and will continue to be ‘actually crazy’. [23] Sedgwick asserts that even in the best of all possible communist utopias there will still be mental anguish and forms of psychosis, depression, trauma and anxiety: winters will still be dark and cold, people will still get old and forget things, some people might still think their plate is a moon that wants to kill them (even if the word ‘schizophrenia’ is no longer used), people will still mourn their loved ones who will still die, babies will still be born and the people who give birth will still be affected by that experience (even if gender relations and child care provisions are radically reconfigured), people will still have accidents and other people will still witness them. Sedgwick praised Laing for de-stigmatizing mental illness but could not accept that mental illnesses were reducible to their social origins.

In Sedgwick’s account another leap in thought separates Sanity, Madness and the Family from Laing’s endeavours and publications between 1964 and 1970, which saw him return to the self as part of his infamous reconceptualization of schizophrenia as a kind of mystical and potentially liberating voyage of discovery. For Sedgwick one of the most dangerous aspects of Laing’s work was the suggestion, evident in his publications from this period, that madness could be understood as a kind of transcendent freedom from social constraints. ‘Madness’ is not a metaphor and neither is it merely a symptom of a sick society. According to Sedgwick, one of the most curious aspects of Laing’s work was that his slide ‘back back back into the slime of an idealistic, privatized mysticism’ [24] paradoxically coincided with his most explicit embrace of radical politics. As such, this period in Laing’s career most preoccupied Sedgwick, as this was when Laing was taken up as an icon of the Left. In Psycho Politics Sedgwick claims that during this time Laing simultaneously drew on materials from distinct philosophical, spiritual, psychological and political traditions, including ‘Marxism, the counter-culture, psychedelic experimentation, romantic-expressionist literature, the critique of the mental institution, the critique of the family, transcendental meditation,

Sartrean existentialism, Freudian psychoanalysis’. [25] For Sedgwick, Laing’s work was defined by a subjective, eclectic and selective engagement with often contradictory materials, and he argues that it would be a mistake to overestimate Laing’s commitment to any particular one of these influences. Sedgwick’s journalistic and academic output was also diverse, encompassing writings on the Black Panther Party, George Orwell, May ’68, Herbert Marcuse, nationalization of Zambian copper mines, the atomic bomb, Che Guevara, the IRA, Nikolai Bukharin and class war in Ghana, but his attack on Laing was not so much an attack on eclecticism as an attempt to expose the inconsistency and superficiality of Laing’s political commitments. Although Psycho Politics contains a generous and at times sympathetic account of the vicissitudes of Laing’s thinking, Sedgwick primarily had a political axe to grind.

Laing and the left

‘The case of R.D. Laing is much less a part of intellectual history than of the social history of stunts, sensations and stampedes’, Sedgwick declared in a 1978 article draft. [26] Sedgwick described Laing as a cult figure and was deeply suspicious of his celebrity status, comparing him to Lawrence Olivier’s Hamlet, a young Brando and, after finally encountering Laing in person, to ‘Ken Dodd on a less ticklish performance’. [27] Sedgwick’s anger in Psycho Politics is not always directed at Laing’s work itself so much as its reception. The level of Laing’s fame was unusual and perhaps even unprecedented for a psychiatrist: his image graced the cover of Melody Maker, he was a guest on mainstream television chat shows, and car bumper stickers were printed that read ‘I’m mad about R.D. Laing!’ [28] Sedgwick remarked with incredulity upon Laing’s status as a public figure whose influence and popularity extended far beyond the remit of the profession of psychiatry:

It is quite common nowadays, if you look at somebody’s bookshelf, to see a book by Laing as the only example of writing in this whole area – no Freud, no Jung, no other psychoanalytic writer or representative from an alternative or rival tradition in psychology. [29]

But he expressed particular alarm at the enthusiastic and apparently uncritical embrace of Laing by the left-wing intelligentsia. [30] In his recent account of the Italian psychiatry movement, John Foot claims that the centrality of psychiatric debates and texts to the political movements that exploded around 1968 have been downplayed by most accounts of the period, arguing that ‘radical psychiatry provided a kind of guide to how to be a ’68er.’ [31] Although Foot does acknowledge that engagement with psychiatric ideas was frequently superficial, he presents radical psychiatric experiments as microcosms of the radical spirit of the age: chaotic, spontaneous, democratic and, as he notes on more than one occasion, smokefilled. [32] Sedgwick was far more cynical, not only in his assessment of Laing’s political convictions and therapeutic practices, but also in his appraisal of the political movements of the 1960s. In his introduction to the 1976 essay collection The Left in Britain, Sedgwick lambasts political ‘tourists’ and luridly compares the activities of the British Left since 1956 to a masturbating adolescent producing a ‘glistening mass’ of ‘futile sex juice’ incapable of fertilizing sufficient ‘cells’ to build a genuine revolutionary movement. [33] Sedgwick’s sexual metaphor frames pleasure for its own sake as pointless unless it is (re)productive;34 he adhered too closely to orthodox Marxism–Leninism to deem exuberant debates, energetic meetings and excessive cigarette smoking politically meaningful in their own right.

As evidence of Laing’s broad countercultural appeal he cites an ad that appeared in the Village Voice: ‘Two chicks who dig Coltrane, Laing and the Grateful Dead are throwing a party next Saturday night for anyone with similar interests.’ [35] As Jeff Nuttall’s paean to London counterculture Bomb Culture makes clear, Laing’s bold pronouncements on the oppressiveness of ‘normality’ and celebration of mystical transcendence resonated with subversive psychedelic swinging 1960s’ milieus. In Nuttall’s narrative Laing appears alongside Beat poets, artists on LSD and jazz musicians as a drunken oracle holding court at wild parties: ‘Ronnie played a Billie Holiday record to cool our minds.’ Laing is described as ministering to people’s alienated states, but alienation in Nuttall’s drugand drink-fuelled account of ‘catatonic ceremonial[s]’ implies alienation from one’s ‘cosmic self’ rather than referring to anything as prosaic as, say, the experience of a worker under capitalism. [36] The bacchanalian scenes recounted in Nuttall’s memoirs seem very distant from the clinical case studies that formed the basis of Laing’s earlier publications. Laing’s The Politics of Experience and The Bird of Paradise (1967) includes little new clinical material and no case histories. Instead, the opening part of the book concludes with a first-hand account of a psychotic ‘voyage’ into inner space experienced by a third party outside of a therapeutic environment and subsequently relayed to Laing. This is followed by a series of impressionistic autobiographical vignettes written in a fragmentary self-consciously literary style, reflecting Laing’s new understanding of psychosis as a form of healing. Indeed, when Laing submitted the manuscript to Penguin for publication they chose to assess it according to its literary rather than its scientific merits and, unlike The Divided Self, did not publish it under the non-fiction Pelican imprint. [37] The text may open with an evocative reference to the ‘fibrillating heartland of a senescent capitalism’ but it ends by advocating a return to some imagined primal un-alienated origin moment. Reading the book’s closing pages puts the occasionally trenchant and pedantic tenor of Sedgwick’s denunciations of Laing into perspective:

What we know is froth and bubbles. Light. The Light of the World, that irradiates me and shines through my eyes, Inner sun that emblazons me, brighter than ten thousand suns … Away, away, away and out, down and out, through and past winds of other worlds, spiral energy dance – through and past galaxies of stars, colours, gems, through and past the beginnings of contentions. [38]

The speech Laing delivered at the Dialectics of Liberation Congress at the Roundhouse in 1967 is an example of him, in terms of both content and context, at his most explicitly political. Yet despite rousingly invoking revolution and armed insurrection the argument advanced in the speech is oblique. Entitled ‘The Obvious’, Laing’s polemic, which he describes as an attempt ‘to see into and through social reality’, focuses on the irrationality of the status quo. Although he diagnoses the ‘world situation’ as pathological, Laing insists upon the fundamental inscrutability and opacity of both the immediate present and history. He envisions society as something like a million bird roast or a giant set of matryoshka dolls extending from the tiny suffocated individual outwards ‘until one reaches a total world system’. It is somewhere in the middle of this ‘interlaced set of subsystems’, between microand macro-levels, that Laing claims ‘revolutionary change’ might occur:

Not through the individual pirouette of solitary repentance on the one hand, or by a seizure of the machinery of the state on the other; but by sudden, structural, radical qualitative changes in the intermediate system levels: changes in the factory, a hospital, a school, a university, a set of schools, or a whole area of medicine, education, etc. [39]

However, his speech focuses only on the individual and, subsequently, on the ‘whole world scene’ and says very little about practical measures that might be taken to transform or overturn these intermediate structures. Laing describes but does little to assail the ‘nature of obedience’, claiming that people are ‘programmed’ to obey without describing who or what is doing the programming or proposing how the process might be combatted. In this general state of ‘mystification’, the only thing people can hope to know is their own ignorance and the only thing they can trust in is a mysterious ‘source much deeper than our own egos’. [40] Although Laing eschews the overtly spiritual vocabulary employed in the contemporaneous Politics of Experience, his speech reaches a similar conclusion: the only way out of the infinitely complex and knotted ‘tapestry’ of society is a retreat into the primal depths of the self.

The peak of Sedgwick’s ire regarding Laing seems to have occurred in the early 1970s, when Laing announced that he was taking a year off in order to meditate in Sri Lanka (then Ceylon). Although he was always suspicious of Laing’s mystical influences, it was not the decision to meditate for a year that horrified Sedgwick so much as Laing’s choice of location. Written in the aftermath of the Janatha Vimukthi Peramuna Insurrection, Sedgwick’s essay ‘R.D. Laing: Self, Symptom and Society’ includes a postscript dated December 1971, which explains that this decision of Laing’s had persuaded Sedgwick that Laing’s political commitments had not only been overestimated but fabricated:

In the light of the intense warfare of repression which the Ceylon government has been waging – with the support of the Buddhist traditional establishment – against the revolutionary youth, trade unionists and peasantry (in the very period Laing decided to go there) one can only appreciate his latest exodus by imagining the position of a Leftist and ‘progressive’ cult hero of the Thirties who decided to go off and enter a Catholic monastery at Burgo behind Franco’s lines at the height of the Spanish Civil War. Withdrawal is not always betrayal: but, in this case, what else is it? [41]

By the time he came to write Psycho Politics, however, his opinion of Laing was less vehemently hostile. In a letter to Raphael Samuel following his meeting with Laing in 1975 he wrote: ‘The trouble is I have now met him and got slightly fond of him: from that moment all my writing on psychiatry and antipsychiatry became suffused with sympathy for his position.’ He also conceded that Laing’s denial of any Marxist influence made him less open to accusations of hypocrisy. This more charitable attitude towards Laing did not prevent Sedgwick from concluding that Laing’s political position was one of resignation, however: ‘cynics are, quite simply, people who have no hope, and therefore have no capacity to express any demands for the future.’ He refused to accept that society was too complex to intervene in and rejected Laing’s regressive impulses. The political question at stake for Sedgwick was therefore: how to care for the mentally ill both in the compromised present and in an ideal future. Rejecting Laing’s philosophical approach, Sedgwick demanded a ‘social and political struggle for the demands of the mentally ill’ with an emphasis on pragmatic, often reformist solutions (or, to borrow his own Trotsky-tinged vocabulary, ‘transitional demands’). [42] Despite these convictions it nonetheless proved difficult to know where to begin.

Cutbacks and breakdowns

At the heart of Sedgwick’s critique of anti-psychiatry is a causal link that he discerns between the emancipatory movements of the 1960s that embraced Laing as an ‘anti-capitalist prophet’ and the brutally individualist conservatism that emerged in the 1970s and 1980s. [43] The anti-psychiatry movement campaigned to close mental health hospitals, and the populations of mental hospitals did indeed dramatically decrease, but for decidedly un-revolutionary reasons. As Sedgwick liked to point out, the person who instigated the closure of asylums in Britain was not R.D. Laing but Enoch Powell. [44] Rather than describing this transition as a bitterly ironic outcome antithetical to the radical goals of the anti-psychiatry movement, he accuses anti-psychiatry of playing into the hands of the Right:

In the realm of psychiatric politics the content of sixties radicalism was highly ambiguous: as prone to demolish the institutions of medical welfare as to enlarge and improve them, as involved in setting the precedents for the burgeoning conservative right as in expressing the concerns of a socially conscious left, as much (finally) simon-pure individualist as it was collectivist in any shape or sense. [45]

Anti-psychiatric literature often compared the asylum to the prison or concentration camp, whereas Sedgwick’s critiques suggest that the movement to abolish asylums ended up more closely approximating a movement to abolish hospitals. Or, to use another institutional analogy, Sedgwick’s arguments imply that the anti-psychiatry movement’s attack on the asylum system could be compared to a campaign against corporal punishment, discipline and hierarchy in schools which produced a movement to abolish education as such. Psycho Politics was completed during Margaret Thatcher’s first term in office. The Mental Health Act, which set out laws for detention and contains the sections under which people can be remanded or hospitalized, was passed in 1983, the year Sedgwick died. Under the current Tory government things (and people) are not getting better. Suicide rates are rising. NHS waiting times are rising. The number of people being sectioned and detained under the Mental Health Act is rising. Death rates of people in psychiatric custody are rising. Many people still first enter the mental health system through contact with the police. Black men are still disproportionately detained under the Mental Health Act. People diagnosed with schizophrenia are still frequently held in restrictive environments. People increasingly need to travel long distances to receive treatment (which is more difficult for people with low incomes). It is becoming increasingly difficult for migrants to access the NHS. Cognitive behavioural therapy (CBT) is given precedence over other (usually longer-term and therefore more expensive) therapeutic methods. The state system still relies heavily on unpaid carers (and the burden of care still falls disproportionately on women). [46] The list could go on and on.

The NHS has recently pledged to invest £1 billion a year in mental health services by 2020–21, but this is a reactive measure that cannot begin to tackle the deepening social iniquities, privations and forms of exploitation and abuse that continually produce and exacerbate forms of mental distress. Confronted with this situation, Laing’s description of the irreducible complexity of the social seems pertinent. It’s difficult to know where to begin. However, unlike Laing, Sedgwick insisted on the possibility and the necessity of beginning the process of loosening the tightly woven social knots without retreating back into the mists of the self.

The kind of reformist arguments proposed by Sedgwick are open to attack on two fronts. First, his emphasis on reforming existing structures might seem to imply an uncritical acceptance of existing psychiatric practices, paradigms and institutions, which the anti-psychiatry movement did so much to undermine. Second, placing emphasis on mental health-care provision could be said to do nothing to curb, and perhaps could even participate in normalizing, the onslaughts of an oppressive society of abusive families, racist police forces, sanction-imposing job centres, transphobic (homophobic, misogynist, Islamophobic…) employers and eviction-notice-sending landlords. Yet it’s hard to know where to begin because not only is a world with rape, police, wage labour, prejudice and private property psychologically damaging, but struggling to create a world with no rape, no police, no work, no prejudice and no private property will be too. Change is arduous. Do all forms of psychiatric treatment necessarily imply a wholesale affirmation of the existing state of things? For Sedgwick, the stakes (that is, the suicide rates) were too high to answer in the affirmative, and his response to such criticisms was combative:

I have caught … a certain pervasive anxiety among my audience, an anxiety which is afraid lest psychiatry may, in the service of our abominable social and economic order, succeed in ‘adjusting’ the mentally ill to its goals. It is as though people believe that there is only a finite pool of grievances and maladjustments available in this society for radicals to work with. The fear is that psychiatry, with its tranquillisers, hospitals and whatnot, may succeed in mopping up this limited supply of miseries, discharging patients into the hell of the factory and the purgatory of the home as permanently ‘cured’ and adjusted robots. Once again, if capitalism could really ‘adjust’ people, through psychiatry or any other technology, who would want to quarrel with it? I myself am perfectly happy to see as many mentally ill persons as possible treated, fully and effectively, in this society: for no matter how many maladjustments may become adjusted through expert techniques, the workings of capitalism will ever create newer and larger discontents, infinitely more dangerous to the system than any number of individual neuroses or manias. [47]

Even if it is sometimes possible to relate particular effects (or symptoms) to particular causes, it is not possible to retroactively transform or eradicate those causes. Placing the emphasis solely on the origins of mental illnesses thus risks leaving people with no reprieve and therefore only contributes to further social immiseration. For Sedgwick, ameliorating distress in the present must form part of a struggle to create a less brutal world in the future.

Sedgwick admired Juliet Mitchell’s Psychoanalysis and Feminism (1974) and credited her as being one of few people who acknowledged the political limitations of Laing’s project. Like Sedgwick, Mitchell questioned the implications of Laing’s appeal to the Left, accusing him of dispensing with class politics and attacking his use of neat pantomimic dichotomies that carved the world into ‘goodies and baddies’. However, despite Sedgwick’s appreciation of Mitchell’s critical defence of Freudian thought, he expressed frustration with her conclusions, which he claimed led down a cul-de-sac. Mitchell argues that the psychic structures identified by Freud as eternal are instead historically contingent and apply specifically to the bourgeois, patriarchal family. Yet she still insists that despite huge shifts in kinship structures and social relations the Oedipus complex remains universal. She concludes by stating that Freud’s work can explain how patriarchy operates; psychoanalysis can account for why women experience themselves as inferior to men rather than affirming or naturalizing their inferior status. She insists that psychoanalysis is rooted in social reality. She does not, however, dispense with the unconscious, which she defines as the space in which patriarchal ideology is inherited and reproduced. Although she asserts that women, whom she compares to the revolutionary proletariat struggling to overthrow capitalism, must organize to overthrow patriarchal structures in the external world, the revolutionary tenor of her argument is undercut by her belief in the intractability of internal unconscious structures; the revolution will be gradual. [48]

Caught between Marxism and psychoanalysis,

Mitchell’s conclusion simultaneously demands radical change and acknowledges that genuine transformation is hard won. Sedgwick claims that this conclusion snatches agency away from women by insisting on the inertia and tenacity of patriarchal structures in the unconscious. [49] Yet the tension between transformation and continuity that Sedgwick identifies in Mitchell’s work also animates his arguments, hence his dismissal of her conclusion for confronting this tension seems unwarranted. Unlike Laing’s description of the ‘spiral of alienation’ which sees norms reproduced across generations and which he can fathom no clear way of ‘disarticulating somewhere from within’, Mitchell does not conclude that social transformation cannot be achieved, only that it will not come about painlessly or quickly. [50] Mitchell does not ascribe to the ‘ahistorical quackery’ Sedgwick identified in Lacanian thought but is motivated by a pragmatic acknowledgment of the weight of history similar to Sedgwick’s own. [51] In an uncharacteristically florid and bombastic passage in Psycho Politics, which deploys a vaguely psychoanalytic vocabulary ordinarily absent from his prose, Sedgwick declares that abolishing physical asylums would not automatically amount to an acknowledgment of the psychic scars on collective memory that their existence had left behind. He insists that their oppressive legacy would live on until that history was properly confronted and worked through:

The repressed truth of the asylum, like the truth of the holocaust repressed in Germany, the truth about Ireland repressed by the British people, the truth about slavery and the bloody defeat of militant labour repressed in America, the truth of the gulag so long repressed in Russia, has a habit of resurfacing now and again in the conscious imagery of different successive generations and publics. The ancestral spectre, bloodstained and foul, stalks the corridors of memory and the newly opened spaces of sensibility. Then – unless it is embraced and released by the spirit of a new transformative purpose – it is pushed back again, to lodge disruptively in the nether-world of the political process. Unacknowledged and yet latently active, it reveals itself on the surface of the citizens’ and the rulers’ behaviour in a thousand dishonest, deflected initiatives of timid restitution or of yet further infamy. Our corner of the late twentieth century has become the battlement on which these walk; and, unless we face these demanding, questioning ghosts on open terms of action, liberation and final exorcism, they will drag us with them into new gulags, new worlds of madness, and new holocausts. [52]

Writing to Samuel, Sedgwick identified a tension between the ‘Promethean and perennial’ in Serge’s writings and claimed that he aspired to achieve both in his work. [53] Like Mitchell, Sedgwick operated in a space of compromise and unresolved contradiction with few easy answers or sexy-sounding Laingian flourishes. In different ways they both acknowledged that the temporality of political change is necessarily disjunctive; it always comes too late.

A frustration with the seemingly inevitable circularity implied by any critique of existing institutions is expressed in Sedgwick’s reflections on his experience working at Grendon Underwood Prison, which was designated in the early 1960s as a gaol for the treatment and investigation of criminals deemed in need of psychiatric attention. [54] Sedgwick worked there as an educationalist for around a year, beginning in 1963. During that time he wrote to his friends Anna Davin and Luke Hodgkin comparing his experience at Grendon to a scene from Andrzej Wajda’s 1956 film Kanal, set during the 1944 Warsaw uprising, in which a group of resistance fighters attempt to escape through the city’s sewers: ‘the cast spend hours wading through an endless tunnel of darkness and excrement, till two of them see a faint gleam of light from the outside world. They struggle through to it, only to find that between them and the open river outside stand iron bars.’ Sedgwick describes this as analogous to his experience working in Grendon, which, despite its reputation as ‘the most progressive prison in Britain and perhaps the world’, is nonetheless still a prison, and despite its ‘gleaming therapeutic apparatus’ is still governed by the ‘perfect, paranoid logic of Maximum Security’. [55] In an article by Sedgwick that appeared in a pamphlet produced in the prison, which includes articles by inmates, guards, therapists, stewards, chaplains and educational workers, Sedgwick declares ‘the purpose of education in the institution must be to combat the absorption of the inmate into prison routines.’ [56] Yet ultimately he acknowledged that education in the institution was part of those routines and no amount of handicraft lessons or amateur dramatics would tear down the prison walls. Working at Grendon Underwood made Sedgwick acutely aware of the limits of reformism and the complicity and coercion that accompany any attempt to effect change from within. Nonetheless he continued to assert that working with people in prisons and mental hospitals, however oppressive those structures, could form part of a movement to abolish or reconfigure those institutions rather than affirm their existence. [57]

Working utopias

‘In another world, and in another orientation, the disturbed and the deranged do not occupy a space different and distinct from everyday humanity.’ [58] Sedgwick imagined that in some distant communist future forms of psychological disturbance would persist, but he envisioned an erasure of the distinction between doctor and patient. The model he offers as an alternative to present configurations is based on Pyotr Kropotkin’s understanding of mutual aid, an example of which Sedgwick claims can be found in the community of Geel, Belgium, a village which since medieval times has settled ‘mad’ people with members of the local community. For Sedgwick, though imperfect, Geel’s attempt at community integration, characterized by freedom of movement and ‘comradely and friendly interaction’ between ‘normals and boarders’, could provide a prototype for a politically radical mental health care system. In contrast to models of ‘community care’ implemented in Britain or America, the care-givers at Geel are not isolated and the burden of care is shared by the whole community rather than falling on individual atomized nuclear families; the system does not rely on expert scientific knowledge so much as on collective and voluntary webs of care. [59]

Sedgwick’s discussion of Geel, which concludes Psycho Politics, suggests that concrete enacted experiments from history might provide glimmers of hope prefiguring alternative possibilities. He momentarily suspends his pragmatic statist concerns in order to propose a positive vision for the future. However, his conclusion is not consistent with his treatment of particular instances of radical experiments in mental health elsewhere in Psycho Politics. Although Sedgwick acknowledges the inadequacy of arguments concerning mental health care provision that focus on the allocation of resources rather than on forms of treatment, in practice he tends to prioritize the former over the latter. For example, he forcefully argues that radical non-professional therapeutic experiments that emerged from activist groups in the 1970s operated like the ‘second economy’ in Eastern bloc countries, a kind of ‘bootlegging private market … rendering therapy into a sector of small-scale commodity production’. Rather than analysing the techniques such groups developed in any detail, he dismisses them for failing to provide a ‘true alternative to the public sector’: ‘all kinds of provoking theories and treatments will germinate and flourish, under the consumers’ control of fashion and the purse-strings.’ [60] Similarly, Sedgwick’s criticism of Laing’s Kingsley Hall hinges on the presumed class composition of the patients, whom he declares were overwhelmingly from bourgeois backgrounds, rather than on the practices developed there. [61] Furthermore, Sedgwick downplays the revolutionary potential of the ‘survivor movement’ in Britain which emerged in the 1970s. The Mental Patients Union (which evolved into the Promotion of the Rights of Mental Patients in Treatment and then into the Campaign Against Psychiatric Oppression) receives only a cursory mention in Psycho Politics. [62] He does not explore the ways in which institutional practices might be resisted by patients through forms of direct action or the possibilities for collective organizing among ‘survivors’; this not only undermines the agency of the people his work claims to speak on behalf of, but also implies a narrow policy-based approach to political strategy, at odds with his engagements in political activism in other arenas. Also, despite his having worked as a psychologist, clinical material and direct accounts of his experiences within institutions are conspicuously absent from Sedgwick’s published writings. Although he praises Laing for humanizing the ‘insane’, the experiences of people diagnosed with mental illnesses are not represented in Sedgwick’s work. Sedgwick’s analysis of Laing importantly highlights Laing’s work’s failure to address ‘nonimmediate social configurations’ or ‘larger complexes of society’ (primarily capitalism). [63] However, his suspicious assessment of Laing’s early case histories for being too poetic not only undermines the capacity of Laing’s patients to express themselves eloquently but also overlooks the potential Laing’s empathetic mode of writing (particularly in The Divided Self) and the forms of interaction it arose from might still contain for understanding people diagnosed with psychiatric disorders in relation to their past lives and present material conditions. [64] Laing’s lens was focused too tightly on the immediate (and particular) family environment for Sedgwick’s liking, but perhaps the frame could be expanded while still drawing inspiration from Laing’s attentive approach to his subjects.

In Contesting Psychiatry, Nick Crossley defines Kingsley Hall and other therapeutic communities as ‘working utopias’, a term also borrowed by Foot in his discussions of Italian radical psychiatric institutions. Perhaps, in addition to Geel, some of the experiments Sedgwick dismissed could also be understood as ‘working utopias’ in a way that might complement rather than undermine his call to campaign for state spending on mental health care in the immediate future. Red Therapy was a leaderless self-help group initiated by activists in London which responded to the strains of living and organizing together collectively. Many of the group were members of East London Big Flame and were involved in solidarity campaigns at Ford’s Dagenham and Lesney’s toy factory, as well as in setting up a food co-op on the Lincoln Estate in Bow. [65] Sedgwick argued that the techniques, or ‘chat’ as he derisively called it, developed by the group only catered to ‘normal’ people experiencing minor levels of distress and could not be applied to acute forms of mental illness. [66] His swift dismissal of the group’s activities echoes the critiques levelled at them at the time by their supposed comrades, who denounced their concern for individual well-being as indulgent, bourgeois and counter-revolutionary. Drawing on an eclectic range of therapeutic traditions and theoretical models – including primal therapy, active meditation, massage, psychoanalysis, Wilhelm’s Reich’s ‘bioenergetics’, guided fantasy, psychodrama, gestalt and anti-psychiatry – the group was an attempt to respond to the corrosive aspects of living within capitalist society, but was also an attempt to confront how difficult it proved to resist social norms:

We wanted to work together politically in nonhierarchical ways, find some kind of sexual freedom and non-oppressive relationships between men and women, adults and children etc. I think we found that it was ALL MUCH HARDER THAN WE THOUGHT. [67]

As such, the various Red Therapy groups (including a mixed gender group, a women’s group and a men’s group) provided supportive if fraught spaces to confront and work through conflicts, anger and exhaustion, and also strove to identify patterns of oppressive behaviour, particularly between men and women. Many participants in the women’s therapy group were active in the Women’s Liberation Movement, and the group responded to the perceived limitations of feminist consciousness-raising groups, which, one member noted, had helped her to understand the external conditions of her oppression as a woman but had not provided a space for her to examine her negative feelings towards herself and other women. It is noted in the pamphlet that the characterization of therapy as ‘self-indulgent’ prevalent in left-wing circles could also be found within the women’s movement and that Red Therapy sought to redress this tendency: ‘Consciousness-raising is certainly a form of therapy, but even so there was always a strong moralism against too much attention being paid to individuals as against the needs of the group or collective.’ The therapy groups that developed were not hermetically sealed utopian spaces but responded directly to immediate material conditions and attempted to provide participants with the psychic resources to continue struggling against those conditions, not to accept or adjust to them. Red Therapy was based on ‘an appreciation that we have to live now – that all gratification cannot be left until after the revolution.’ [68] Though the groups were small, their attempt to identify the ways in which large-scale systemic and structural forms manifested themselves on an individual level distinguishes the project from what Sedgwick describes as Laing’s myopic interest in ‘small social arenas’. [69]

Serge presented his ‘mad’ wife as a casualty of a revolutionary situation gone wrong and situated healing processes in spaces physically and figuratively cordoned off from political struggle proper, whereas Red Therapy deemed forms of ongoing emotional support integral to revolutionary political movements. In an obituary of Trotsky’s biographer Isaac Deutscher, Sedgwick claims that by treating history as tragedy Deutscher failed to depict the quotidian contradictions and vacillations that characterize collective struggles:

In the politics we know of in our own lives or on the news, there are: victories, losses, massacres, deadlocks, retreats, advances; those who stay, those who fall out, those who sell out; those who push, those who cringe, those who try to postpone the choice whether to push or to cringe; in groups and in individuals, there are hopes, hesitations, excitements, evasions, triumphs, fatalities; there is endurance and there is fatigue. [70]

By framing his polemic primarily as a defence of the state provision of mental health services, Sedgwick risked overlooking the glimmers of hope in the methods and practices developed by therapeutic initiatives like Red Therapy, which explicitly addressed themselves to experiences of falling out, pushing, cringing, endurance and fatigue. Spaces of support, care and mutual aid like this will be necessary to mount and sustain the kind of large-scale social movements Sedgwick deemed necessary to dramatically change the way our society treats and understands mental illness.

9. ^ Sedgwick to Richard Greeman, 11 March 1983, Box 1/9–1/17, Folder 1/10. In 1983 Sedgwick sought treatment for anxiety and insomnia and claimed to have experienced momentary hal ucinations during which he was ‘actual y barmy’. He described these experiences as a response to the strains of his relationship with his second wife (from whom he was legal y separated but with whom he was still living at the time of his death).

10. ^ Sedgwick described Deleuze and Guattari’s Anti-Oedipus as an ‘appal ing piece of rubbish’. See Sedgwick, ‘The Everyday Life of Psychopathologies’, Quarto, December 1979, p. 4.

13. ^ For a discussion of Lessing’s engagement with Laing published shortly after this conversation, see Marion Vlastos, ‘Doris Lessing and R.D. Laing: Psycho Politics and Prophecy’, PMLA, vol. 91, no. 2, 1976, pp. 245–58. In its interweaving of the ‘cracking up’ of the Communist Party with the psychological ‘cracking up’ of its protagonist, Lessing’s The Golden Notebook (1962) succeeds in directly confronting the damaging aspects of political struggle in a manner only hinted at by Serge.

19. ^ ‘When I certify someone insane, I am not equivocating when I write that he is of unsound mind, may be dangerous to himself and others, and requires care and attention in a mental hospital.’ Although, of course, the kinds of treatments Laing advocated were distinct from those practised in most mainstream mental hospitals. Laing, The Divided Self, p. 27.

20. ^ Sedgwick, Psycho Politics, p. 32. 21. Ashley Tauchert discusses the fraught debates around language in the context of discussions of ‘madness’ and defends the ‘medical model’ despite its deficiencies. She cites the group ‘mind freedom’, a radical group who demand that the term ‘mental il ness’ be replaced. Ashley Tauchert, Critical Quarterly, vol. 57, no. 4, 2015, pp. 45–57; 47–8.

27. ^ See Peter Sedgwick, ‘Doctor for an Epoch’, Draft for a Radio 3 programme on R.D. Laing, 1972, Box 4/1–4/5, Folder 2/028; and Sedgwick to David Widgery, October 1975, Box 1/9–1/17, Folder 1/11.

28. ^ These examples appear in Nick Crossley’s discussion of Laing and anti-psychiatry. Crossley suggests Laing’s embrace of left-wing ideas and attempts to appeal to a mass non-specialist audience coincided with his rejection by the medical establishment. See Nick Crossley, Contesting Psychiatry: Social Movements in Mental Health, Routledge, Abingdon, 2006, pp. 88–111.

29. ^ Sedgwick, ‘Doctor for an Epoch’. In a recent article based on an analysis of materials from the Penguin archive, Gavin Mil er examines the publisher’s decision to publish works by ‘bankable’ anti-psychiatrists, marketed to young radicals, despite peer reviewers’ concerns about the scientific legitimacy of works such as Laing’s TheDivided Self. David Cooper came to rely on royalties from publications as his main source of income. Gavin Mil er, ‘Psychiatric Penguins: Writing on psychiatry for Penguin Books, c. 1950–c. 1980’, History of the Human Sciences, vol. 28, no. 4, 2015, pp. 76–101.

30. ^ For an example of an analysis of Laing which takes his work’s compatibility with Marxism for granted, see Andrew Col ier, R.D. Laing: The Philosophy and Politics of Psychotherapy, Harvester, Hassocks, 1977. Fol owing the publication of a critical article in the Socialist Worker (cited above), Sedgwick received a barrage of indignant letters, indicating the extent to which his attack on anti-psychiatry diverged from the prevailing opinions of people in his political circles.

34. ^ Sedgwick had an ongoing preoccupation with erotic questions. In 1959 he published an article cal ing for the nationalization of the London Rubber Company, which had a monopoly on the production of Durex branded condoms, demanding ‘the common ownership of the means of reproduction’. (Sedgwick, ‘The Politics of Family Planning’, Clarion 7, 1959, pp. 7–8; 8). In a letter to Widgery he described sexuality as a ‘license to kil ’, a destructive force which complicated collective political processes, and he jokingly imagined ‘some Marxist old folks home’ in which people might succeed in working together political y without trying to sleep with one another (Sedgwick to Widgery (April 197?), Box 1/9–1/17, Folder 1/11). Shortly before his death he claimed that he was interested in writing a ‘serious and trenchant analysis’ of pornography, ‘dealing with some intensely political aspect of personal life’ (Sedgwick to Tamara and David Ross (August 1982?), Box 1/9–1/17, Folder 1/16).

43. ^ Sedgwick, Psycho Politics, p. 123. Although deinstitutionalization was not as rapid in Britain as in America, the inpatient population of British mental hospitals approximately halved between the mid-1950s and early 1980s. For a comparison of the two national contexts, see Andrew Scul , Decarceration: Community Treatment and the Deviant, A Radical View, Prentice Hal , Englewood Cliffs NJ, 1984, pp. 166–9. Scull controversial y argued that the role of psychoactive drugs in bringing about mass closures of asylums in America had been overestimated, proposing that closures had instead responded to fiscal crisis.

Although Sedgwick described himself as a feminist, expressed solidarity with the Women’s Liberation Movement and did not abjure housework or childcare responsibilities, his correspondence is nonetheless laced with misogynistic remarks. In a letter to Widgery, for example, he complains about attending a meeting where a woman spoke about vaginal orgasms: ‘these remarks seem to correspond to a particularly mousy or passive woman who has never known very deep sex with a man’ (Sedgwick to Widgery, 24 May 1974, Box 1/9/–1/17, Folder 1/11). Elsewhere he claims that he had an ‘unfortunate’ tendency to al ow women to dominate him ‘on the spurious grounds that he must have them as equals’ (Sedgwick to Widgery, October 1975, Box 1/9–1/17, Folder 1/11).

57. ^ The historical fates of prisons and mental hospitals are, of course, intertwined. In America the relation between the two institutions is particularly stark: a steep decline in mental hospital populations coincided with a dramatic increase in prison populations. Scul , Decarceration, p. 175.

59. ^ Sedgwick, Psycho Politics, p. 287. Sedgwick was concerned that critiques of mental institutions that advocated ‘community care’ risked reinforcing the traditional division of labour in the home, ‘tying down women in servicing roles’ (Psycho Politics, p. 273). As he wrote to Widgery: ‘Why are you so eloquent on captive housewives being label ed ‘depressive’ and so uncritical of captive households being label ed as targets for family therapy? The problem is surely one of finding alternatives both to the family and to the institution’ (Sedgwick to Widgery, 15 February 1983, Box 1/9–1/17, Folder 1/11).

63. ^ Sedgwick, Psycho Politics, p. 124 (the former phrase is taken from Russell Jacoby).

64. ^ On Sedgwick’s discussion of the limits of Laing’s literary style, see Sedgwick, ‘Everyday Life of Psychopathologies’. Benjamin Noys makes a similar point about the eloquence of Laing’s patients in ‘Legacies of Anti-Psychiatry and R.D. Laing’, Verso Blog, 9 October 2015, www.versobooks.com/blogs/2276[archive]–legacies-of-anti-psychiatry-and-r-d-laing; accessed 26 February 2016.

66. ^ Sedgwick, Psycho Politics, p. 251. 67. Red Therapy pamphlet, London, 1976, p. 24. See www.eastlondonbigflame.org.uk/files/Red[archive]%20Therapy%20 pamphlet_1.pdf; accessed 26 February 2016. Thanks to members of Red Therapy for sharing their experiences at events at MayDay Rooms in February 2015 and at ‘Reality Check: A Symposium on Art, Psychology and the Limits of Community’ at University Col ege London in March 2016.